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TEMPORARY FOOD VENDOR’S APPLICATION <br />required to return a signed and completed copy of this checklist to <br />1. <br />2. <br />Phone: <br />3. <br />4. <br />5. <br />6. <br />7. <br />9.the hot and cold holding of potentially hazardous 5k <br /> On-site hose bib that is connected to a potable water source. <br /> Other (specify): <br />are those which sell beverages from <br />sources. <br />Note: The only operations not required to provide enclosed booths <br />approved dispensers, or prepackaged foods from approved <br />Approved water for drinking, utensil and hand washing will be provided in my booth by the following methods: <br />^Approved bottled water. <br />Electricity is provided for my booth’s use: Yes No <br />I am providing an accurate probe thermometer to measure <br />foods during all times of booth operation: (ZfYes No <br />Date(s): 12 c il r <br />All food vendors (both for profit and non-profit) are i <br />the festival coordinator three (3) weeks prior to this event. <br />1. Name of Event: <br />List food to be sold or given to the public: "Vt'' ' QS. j i <br />I am providing food that is NOT prepared at home: Yes No <br />All food is prepared on-site or is from approved commercial facilities: Effres No <br />Name of facility: C-., ■ <br />Address of facility: 14 <br /> Alternate: ( ) _______ <br />Ca-Wing_______ <br />rC(A <br />Ffoy )in Phone: (Ar) <br />' ^sTand the puttfe? follOWiri9: (t° protect my unPacka9ed food and food-preparation areas from flies, <br /> A booth with walls and ceiling constructed of either wood, canvas, plastic, similar material and fine mesh fly <br />screening, completely enclosing open food areas. It will also have a smooth and cleanable floor (concrete <br />areas fromethepubHcand Sm0°th W00d are accePtable) and constructed to separate food and food preparation <br />Smother (specify): <br />The following is information about my organ ization/business; <br />Name of organization/business: V U 'C;'S V YA CCA <br />Address: